By day, Martin Healey teaches science at Waseca High School.
At home, his pager stays on for 12 hours two nights a week and occasionally on weekends, alerting him to calls for the Wells Community Ambulance Service, with which the 48-year-old has served for the past twelve years. .
Such is the life of an EMT with a rural emergency medical service.
“The recruiting never stops,” said Healey, Wells’ former team captain and dedicated public servant.
“We try to build a cohort of around 10 (candidates) every year, but training is a big commitment (160 hours of training), and we know not everyone will be successful.”
With two ambulance platforms and 20 paramedics serving a local population of approximately 2,400 people and the surrounding area, Wells is well placed to provide emergency medical transport.
But Minnesota’s rural EMS system isn’t necessarily on a solid footing overall, with some areas lacking sufficient numbers of trained paramedics and others strapped for cash.
These challenges led the Center for Rural Policy and Development to host a recent webinar that attracted 150 virtual attendees.
“Rural health is about access,” said panelist Mark Jones, executive director of the Minnesota Rural Health Association.
“When you call 911, you hope someone answers. The boundaries of the primary service area don’t need to remain so static.”
This back and forth between major service areas, resulting in occasional reluctance to collaborate or consolidate emergency medical services, is a problem that needs to be addressed.
Kelly Asche, research associate at the Center for Rural Policy and Development and host of the webinar, provided background on the topics.
“Minnesota has eight EMS Regulatory Board program regions and more than 250 ambulance service areas,” Asche said.
“It’s better than many other states, but what’s stopping a collaborative strategy? »
The origin of ambulance services dates back to the Civil War and evolved with the founding of the American Red Cross and subsequent wars, Asche said.
When the federal government began to consider injuries from motor vehicle crashes and cardiac incidents as public health concerns and infused financial support (via the US Department of Transportation) in the 1960s and 1970s, EMS services took off across the country and became points of civic pride. .
“Communities have started ambulance services with these funds,” Rasche said. “They were made up of people’s friends and neighbors and were present at football matches.
“There was pride in the history of being able to offer these services – and that can be difficult to disentangle.”
In the 1980s, financial support from the federal government receded, placing the costs on the feet of each local service.
Today, it contributes to inequality across the state; the annual price to operate an ambulance with 24/7, 365 on-call access is between $500,000 and $600,000.
And that’s because many rural EMS programs rely on “volunteers,” who are often modestly paid, but not at levels that are truly commensurate with the time they dedicate and the services they provide.
“Is it time to reconsider volunteers in general, and do we need to come to a place where every agency has paid staff?” Rasche asked. “And how is it paid for?”
As things stand, too many EMS budgets are balanced on the backs of those doing the work, Jones said.
“I don’t know if we need to move away from volunteers altogether – there’s a place for that somewhere – but can we rely on them as a core workforce? Absolutely not,” Jones said.
With volunteer EMS crews, variability is the rule when it comes to whether their employers continue to pay them for times when they are called away from work for emergency errands – and whether they are paid, it is the employers who pay the dough.
“But a tax district would be a tough thing to sell in my rural communities,” said Ann Jenson, Dawson-based executive director of the MN EMS Regulatory Board’s Southwest Regional Program and another webinar panelist.
Many communities, she pointed out, tend to fund fire departments at much higher rates than ambulance services, but still continue to rely on the latter.
“As our departments get smaller and our patients grow, we rely on law enforcement and firefighters to help lift,” Jenson said.
“We are a team and we need each other, so we have to figure out how to make it work.”
Gordon Vosberg, director of EMS for CentraCare Health at Monticello and a webinar panelist, thinks finding a way to collaborate where possible — even if services aren’t necessarily consolidated — might be the best path.
For example, its CentraCare division had six independent ambulance services, each with its own manager. About 2 and a half years ago, they started to organize staff orientations at the same time, recruit as a group, buy as an entity and train together.
“We’re now down to two dispatch centers so we can have more control over things, and the two larger primary service areas are supporting the lower primary service areas,” Vosberg said.
“Even with this integration, the important local element with community collaboration between police and firefighters is something no one wants to lose.”
Joel Polzin, fire chief at Nicollet for several years and a veteran of the Nicollet Fire Department for three decades, sees the wisdom in this approach.
“The ambulance services rely on us, and there are times when the firefighters come first,” Polzin said. “Then we took a lot of vital signs so that when the ambulance team arrives they can focus on the transport.
“We must work together to provide the best care possible, and it takes a cooperative effort to ensure the health and safety of our citizens.”
Lest urban residents think rural EMS services aren’t their problem, think: be for you?
“In an emergency situation, four to five minutes can feel like 15 to 20 to the patient,” Polzin said.
“In reality, volunteers from different communities are quite quick to get people where they need to go.
Healey is among those pledging to do his part to help his neighbors in need, and he’ll likely continue “as long as my back can handle it”, although the existence of hydraulic beds provides a literal lift when loading. and unloading patients.
Healey added an emergency responder class to his teaching repertoire at Waseca High School last year, and he said the response from students has been “fabulous”.
“Kids understand the need for it,” Healey said.
This must be encouraging news for professionals like Vosberg, Jones and Jenson, who daily seek ways to support the rural EMS programs that exist to protect and serve citizens in times of crisis.
“We would like to align all of that and support the volunteers that we have,” Jenson said. “Recruitment and retention is the million dollar question, and it will take us all working together to figure out how we will do that going forward.”